Provider Demographics
NPI:1831969104
Name:MAYNORE, SHERI LYNN (MA)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:MAYNORE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:LYNN
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7810 S YATES BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-5108
Mailing Address - Country:US
Mailing Address - Phone:520-730-3753
Mailing Address - Fax:
Practice Address - Street 1:8707 SKOKIE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2281
Practice Address - Country:US
Practice Address - Phone:847-568-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health